医院-社区-家庭三位一体健康教育模式对胰岛素废弃针头居家处置的影响被引量：8

Effects of hospital-community-family trinity health education model on household disposal of insulin waste needles

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摘要目的对胰岛素居家注射患者进行医院-社区-家庭三位一体健康教育模式管理,探讨其对医疗废物知识知晓情况及废弃针头规范处置情况的影响。方法于医院门诊利用自编问卷对胰岛素居家注射患者278例进行医疗废物相关知识和胰岛素废弃针头处置情况的调查,针对存在的共性问题,开启医院-社区-家庭三位一体健康教育管理模式,同步进行相同问题的健康教育,1、3、6个月后观察胰岛素废弃针头处置情况、医疗废物知识知晓情况、锐器盒回收等情况。结果健康教育1、3、6个月后,胰岛素废弃针头最终混入生活垃圾的比率分别为51.8%(144/278)、15.1%(42/278)、4.7%(13/278),与首次结果99.6%(277/278)比较,差异有统计学意义(χ^(2)=173.046、406.136、502.346,P<0.01);首次调查发现,患者回答医疗废物知识各条目的正确率较低,健康教育1、3、6个月后,医疗废物相关知识各项目的正确率均明显高于首次调查结果,差异有统计学意义(OR=3.016~3548.810;95%CI 2.108~917.869,4.315~19777.062;χ^(2)=25.180~524.895;P<0.01);健康教育1、3、6个月后,医疗废物知识合格率分别为82.4%(229/278)、75.9%(211/278)、97.1%(270/278),较首次结果6.5%(18/278)明显提高,差异有统计学意义(χ^(2)=324.328、273.712、453.832,P<0.01)。乙型肝炎患者的锐器盒回收情况相对良好。结论医院-社区-家庭三位一体健康教育模式可以提高教育对象的广度和深度,既可提高胰岛素居家注射患者医疗废物相关知识,又可提高胰岛素废弃针头规范处置能力,随着时间推移,健康教育效果持续良好,这种一体化健康教育模式值得临床推广。 Objective To conduct the integrated management of hospital,community and family for patients with insulin injection at home,in order to explore the influence of this trinity health education model on the knowledge of medical waste and the standard disposal of discarded needles.Methods The self-designed questionnaire was used to investigate the knowledge and disposal of medical waste in outpatients,and the causes were analyzed carefully after the problems were found.The hospital,community and family were timely communicated and fed back to the ward and community.After 1,3 and 6 months of educational intervention,the disposal of insulin needles,the knowledge of medical waste and the recovery of sharp instrument boxes were observed.Results After 1,3 and 6 months of health education,the final rate of insulin needles mixed into domestic waste was 51.8%(144/278),15.1%(42/278)and 4.7%(13/278),respectively.Compared with the first result of 99.6%(277/278),the difference was statistically significant(χ^(2)=173.046,406.136,502.346,P<0.01);The first survey found that the correct rate of responding to medical waste knowledge items was low.After health education for 1,3 and 6 months,the correct rate of medical waste related knowledge items was significantly higher than that of the first survey,and the difference was statistically significant(OR=3.016-3548.810;95%CI 2.108-917.869,4.315-19777.062;χ^(2)=25.180-524.895;P<0.01);After 1,3 and 6 months of health education,the qualified rate of medical waste knowledge was 82.4%(229/278),75.9%(211/278)and 97.1%(270/278),respectively,which was significantly higher than the first result of 6.5%(18/278).The difference was statistically significant(χ^(2)=324.328,273.712,453.832,P<0.01).The sharp box recovery of hepatitis B patients was relatively good.Conclusion Hospital-community-family Trinity health education model can improve the breadth and depth of education objects,not only can improve the knowledge of medical waste related to insulin injection patients at home,but also can improve the standardized disposal ability of insulin waste needles.With the passage of time,the effect of health education continues to be good.This integrated health education model is worth popularizing in clinic.

作者王翠玲全蕾李琳娜崔霞张家香盛林肖娟晋运玲 Wang Cuiling;Quan Lei;Li Linnan;Cui Xia;Zhang Jiaxiang;Sheng Lin;Xiao Juan;Jin Yunling(Internal Medicine Department,the Second Hospital of Shandong University,Jinan 250033,China;Obstetric Clinic,the Second Hospital of Shandong University,Jinan 250033,China;Hand foot surgery,the Second Hospital of Shandong University,Jinan 250033,China;Neurosurgery Department,the Second Hospital of Shandong University,Jinan 250033,China;Community,the Second Hospital of Shandong University,Jinan 250033,China;Pain Clinic,the Second Hospital of Shandong University,Jinan 250033,China;Evidence Based Medicine,the Second Hospital of Shandong University,Jinan 250033,China)